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Consensus bundle on cardiac conditions in obstetric care

9 Mar, 2023 | 14:14h | UTC

Alliance for Innovation on Maternal Health: Consensus Bundle on Cardiac Conditions in Obstetric Care – Obstetrics & Gynecology

 

SR | Spinal cord stimulation for low back pain provides no sustained clinical benefits compared to placebo

9 Mar, 2023 | 14:12h | UTC

Summary: Spinal cord stimulation (SCS) is a surgical procedure used to treat persistent low back pain by sending electrical signals via implanted electrodes into the spinal cord. The review included 13 studies (randomized controlled trials and cross‐over trials) with 699 participants.

Most of the studies were focused on short-term effects (less than one month), but the review found it is uncertain whether spinal cord stimulation can improve outcomes in the immediate term compared with placebo. At six months, SCS probably does not improve back or leg pain, function, or quality of life compared with placebo, with moderate certainty of evidence. Adverse events were also reported, including infections, neurological damage, and lead migration requiring repeated surgery.

The review concluded that the data does not support the use of SCS to manage low back pain outside a clinical trial. Current evidence suggests SCS probably does not have sustained clinical benefits that would outweigh the costs and risks of this surgical intervention.

Article: Spinal cord stimulation for low back pain – Cochrane Library

Summary: Spinal cord stimulation for low back pain – Cochrane Library

 

Commentary from the author on Twitter

 

M-A | Opioids for breathlessness in heart failure have no significant benefits and increase adverse effects

9 Mar, 2023 | 14:11h | UTC

Summary: The study aimed to assess the effectiveness of opioids in treating breathlessness in patients with heart failure and to evaluate their adverse effects. The authors conducted a systematic review of randomized controlled trials (RCTs) and included eight studies with 271 patients.

The results showed that opioids did not provide significant benefits in managing breathlessness in advanced HF and significantly increased the risk of adverse events such as nausea, vomiting, and constipation.

The authors suggest that opioids should be considered only as a last resort when other interventions have failed or in emergency situations.

Article: Effect of opioids for breathlessness in heart failure: a systematic review and meta-analysis – Heart

 

RCT | Assessment of a text message–based smoking cessation intervention for adult smokers

9 Mar, 2023 | 14:09h | UTC

Assessment of a Text Message–Based Smoking Cessation Intervention for Adult Smokers in China: A Randomized Clinical Trial – JAMA Network Open

 

Commentary on Twitter

 

Single-arm study | Gene therapy with Etranacogene Dezaparvovec for Hemophilia B

9 Mar, 2023 | 14:07h | UTC

Gene Therapy with Etranacogene Dezaparvovec for Hemophilia B – New England Journal of Medicine (link to abstract – $ for full-text)

Commentary: Gene Therapy Beneficial for Patients With Hemophilia B – HealthDay

 

M-A | Tailoring the optimal duration of the extended adjuvant endocrine therapy in patients with early-stage breast cancer

9 Mar, 2023 | 14:06h | UTC

Tailoring the optimal duration of the extended adjuvant endocrine therapy in patients with early-stage breast cancer. A systematic review and meta-analysis of randomized clinical trials – The Breast

 

Review | Treatment of systemic sclerosis

9 Mar, 2023 | 14:05h | UTC

State-of-the-art evidence in the treatment of systemic sclerosis – Nature Reviews Rheumatology

 

Practice Guide | Acquiring tissue for advanced lung cancer diagnosis and comprehensive biomarker testing

9 Mar, 2023 | 14:04h | UTC

Acquiring tissue for advanced lung cancer diagnosis and comprehensive biomarker testing: A National Lung Cancer Roundtable best-practice guide – CA: A Cancer Journal for Clinicians

 

RCT/extended follow-up | Lenvatinib plus pembrolizumab vs. sunitinib in patients with advanced renal cell carcinoma

9 Mar, 2023 | 14:03h | UTC

Lenvatinib plus pembrolizumab versus sunitinib as first-line treatment of patients with advanced renal cell carcinoma (CLEAR): extended follow-up from the phase 3, randomised, open-label study – The Lancet Oncology (link to abstract – $ for full-text)

Original Study: Lenvatinib plus Pembrolizumab or Everolimus for Advanced Renal Cell Carcinoma – New England Journal of Medicine (link to abstract – $ for full-text)

 

Commentary on Twitter

 

SR | There is insufficient evidence to recommend pharmacological treatments for central sleep apnea in adults

9 Mar, 2023 | 14:01h | UTC

Pharmacological treatment for central sleep apnoea in adults – Cochrane Library

Summary: Medicines for central sleep apnoea in adults – Cochrane Library

 

Cohort Study | Personalized progression prediction in patients with MGUS or smouldering multiple myeloma

9 Mar, 2023 | 13:59h | UTC

Personalised progression prediction in patients with monoclonal gammopathy of undetermined significance or smouldering multiple myeloma (PANGEA): a retrospective, multicohort study – The Lancet Haematology

Invited Commentary: The PANGEA model: catching the drift from precursor conditions to myeloma in individual patients – The Lancet Haematology

 

Commentary from the author on Twitter (thread – click for more)

 

Ileal pouch-anal anastomosis in the older adult: a review of postoperative outcomes and pouchitis treatment

9 Mar, 2023 | 14:00h | UTC

Ileal Pouch-Anal Anastomosis in the Older Adult: a Review of Postoperative Outcomes and Pouchitis Treatment – Current Treatment Options in Gastroenterology

 

RCT | Home telemonitoring vs. hospital care in complicated pregnancies in the Netherlands

9 Mar, 2023 | 13:58h | UTC

Home telemonitoring versus hospital care in complicated pregnancies in the Netherlands: a randomised, controlled non-inferiority trial (HoTeL) – The Lancet Digital Health

 

Commentary on Twitter

 

M-A | Efficacy of mesalamine in irritable bowel syndrome

9 Mar, 2023 | 13:56h | UTC

Systematic Review and Meta-analysis: Efficacy of Mesalamine in Irritable Bowel Syndrome – Clinical Gastroenterology and Hepatology

 

Review | Nutritional management of the infant with chronic kidney disease stages 2–5 and on dialysis

9 Mar, 2023 | 14:18h | UTC

Nutritional management of the infant with chronic kidney disease stages 2–5 and on dialysis – Pediatric Nephrology

 

RCT | Bempedoic acid shows modest reduction in cardiovascular events for statin-intolerant patients

8 Mar, 2023 | 14:39h | UTC

Summary:

Bempedoic acid is an ATP citrate lyase inhibitor that reduces LDL cholesterol levels and is associated with a low incidence of muscle-related adverse events. The study enrolled 13,970 patients at increased cardiovascular risk, with 6,992 randomized to bempedoic acid and 6,978 randomized to placebo, with a median duration of follow-up of 40.6 months.

The study found that bempedoic acid was associated with a statistically significant 13% reduction in the primary endpoint of major adverse cardiovascular events, which included death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, or coronary revascularization. However, the absolute risk reduction of events was modest, at 1.6% over nearly four years.

The study also reported higher incidences of gout and cholelithiasis with bempedoic acid compared to placebo, as well as small increases in serum creatinine, uric acid, and hepatic-enzyme levels.

Article: Bempedoic Acid and Cardiovascular Outcomes in Statin-Intolerant Patients – New England Journal of Medicine (link to abstract – $ for full-text)

Commentaries:

CLEAR Positives and Cautions With Bempedoic Acid for Statin Intolerance – Medscape (recommended reading – free registration required)

Cardiovascular Outcomes After “Statin-Intolerant” Patients Take Bempedoic Acid – NEJM Journal Watch (free for a limited period)

 

Commentary on Twitter

 

CDC Study | Estimates of serial interval and incubation period for mpox virus infection in the US

8 Mar, 2023 | 14:34h | UTC

Summary:

Monkeypox cases have been reported globally since May 2022, with most transmission occurring through close physical contact associated with sexual activities among men who have sex with men.

This study presented the estimated mean serial interval and incubation period for monkeypox virus infection based on data collected from 12 US health departments. The serial interval is the time between symptom onset in a primary case-patient and symptom onset in the secondary case-patient. It is critical for estimating the effective reproduction number and forecasting incidence, both of which are important for understanding the course of an outbreak and the effect of interventions.

The results indicate that the mean estimated serial interval for symptom onset is 8.5 days, while the mean estimated incubation period is 5.6 days.

Article: Interval and Incubation Period for Monkeypox Virus Infection in the United States: Findings from 12 Health Departments” – Emerging Infectious Diseases

Commentary: 8.5 days elapse between successive mpox cases, study estimates – CIDRAP

 

RCT | Combination of intravenous doxycycline and azithromycin better than either drug alone for severe scrub typhus

8 Mar, 2023 | 14:36h | UTC

Summary:

The study aimed to compare the efficacy of intravenous doxycycline, azithromycin, or a combination of both drugs in treating severe scrub typhus. The study randomized 794 patients with severe scrub typhus and at least one organ involvement to receive a 7-day course of intravenous doxycycline, azithromycin, or both.

The primary outcome was a composite of death from any cause at day 28, persistent complications at day 7, and persistent fever at day 5. The study found that combination therapy with intravenous doxycycline and azithromycin was a better therapeutic option for treating severe scrub typhus than monotherapy with either drug alone.

Article: Intravenous Doxycycline, Azithromycin, or Both for Severe Scrub Typhus – New England Journal of Medicine (link to abstract – $ for full-text)

News Release: A combination therapy is found to be more effective on severe scrub typhus – University of Oxford

 

Commentary on Twitter

 

M-A | Non-occupational physical activity and risk of cardiovascular disease, cancer and mortality outcomes

8 Mar, 2023 | 14:33h | UTC

Summary:

The study aimed to determine the association between non-occupational physical activity and chronic disease and mortality outcomes in the general adult population. The systematic review and meta-analysis included 196 articles covering 94 cohorts and over 30 million participants.

The results showed that higher activity levels were associated with a lower risk of all outcomes. The strongest associations were observed for all-cause and cardiovascular disease mortality, with weaker associations for cancer incidence.

The study also found that appreciable population health benefits could be gained from increasing physical activity levels of people who are inactive to just half the current health recommendations; doing that could prevent one in 10 premature deaths.

The findings support the current physical activity recommendations and suggest that even small increases in non-occupational physical activity in inactive adults can provide substantial protection against chronic disease outcomes.

It’s worth noting, however, that this study has the usual limitations of observational studies since all the included studies are cohort studies. Therefore, the results are subject to residual confounding, meaning that other factors not measured or accounted for in the studies could influence the observed associations.

Article: Non-occupational physical activity and risk of cardiovascular disease, cancer and mortality outcomes: a dose–response meta-analysis of large prospective studies – British Journal of Sports Medicine

News Releases:

One in ten early deaths could be prevented if everyone managed at least half the recommended level of physical activity, say a team led by researchers at the University of Cambridge

1 in 10 early deaths averted if everyone met physical activity targets – BMJ Newsroom

 

Perspective | Antipsychotics are increasingly being prescribed to children – here’s why we should be concerned

8 Mar, 2023 | 14:29h | UTC

Antipsychotics are increasingly being prescribed to children – here’s why we should be concerned – The Conversation

Original study: Cohort Study | Trends in antipsychotic prescribing to children and adolescents in England

 

Perspective | Dangerous selfies aren’t just foolish. We need to treat them like the public health hazard they really are

8 Mar, 2023 | 14:30h | UTC

Dangerous selfies aren’t just foolish. We need to treat them like the public health hazard they really are – The Conversation

 

FDA panel endorses 2 RSV vaccines for older adults, but flag at potential increased risk of Guillain-Barre

8 Mar, 2023 | 14:27h | UTC

Pfizer vaccine:

In close vote, FDA advisers recommend Pfizer RSV vaccine for those 60 and older – CIDRAP

FDA advisors recommend first-ever RSV vaccine from Pfizer, despite possible Guillain-Barre risks – CNBC

GSK’s vaccine:

FDA panel recommends GSK’s RSV vaccine for ages 60 and up – CIDRAP

FDA advisors recommend GSK’s RSV vaccine for older adults, but flag potential safety risks – CNBC

See also: Rare neurological condition is ‘important potential risk’ of Pfizer’s RSV vaccine, FDA says – CNN

 

Perspective | How to not be completely wrong about masks

8 Mar, 2023 | 14:25h | UTC

How to not be completely wrong about masks – The Munro Report

Related:

SR | Physical interventions to interrupt or reduce the spread of respiratory viruses

Let’s Do the Cochrane Review of Physical Measures to Reduce the Spread of Viruses – Sensible Medicine

Hospital masking should be optional – Sensible Medicine

Face masks to prevent transmission of respiratory infections: Systematic review and meta-analysis of randomized controlled trials on face mask use – PLOS One

RCT | Medical masks vs. N95 respirators for preventing COVID-19 among health care workers.

Science, Competing Values, and Trade-offs in Public Health — The Example of Covid-19 and Masking – New England Journal of Medicine

 

Commentary on Twitter

 

Position Statement | Telemedicine in obstetrics — quality and safety considerations

8 Mar, 2023 | 14:23h | UTC

Society for Maternal-Fetal Medicine Special Statement: Telemedicine in obstetrics—quality and safety considerations -American Journal of Obstetrics & Gynecology

 

Commentary on Twitter

 

Consensus Paper | Pain management and opioid stewardship in adult cardiac surgery

8 Mar, 2023 | 14:22h | UTC

Pain management and opioid stewardship in adult cardiac surgery: Joint consensus report of the PeriOperative Quality Initiative and the Enhanced Recovery After Surgery Cardiac Society – The Journal of thoracic and cardiovascular surgery

 

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